Palliative care in neurology.

This article defines the evolving role of the neurologist as a provider of palliative care. As neurologists care for chronically and critically ill, dying patients, and individuals whose diseases are incurable at the time of diagnosis, clinical competence requires expertise in the principles and practice of palliative medicine. Multiple studies suggest that despite available guidelines many patients with neurological disease suffer from pain, dyspnea, and other symptoms at or near the end of life. Recommendations from the American Academy of Neurology and Institute of Medicine are provided and the many ongoing educational efforts aimed at closing the existing gap in knowledge and improving patient care are reviewed.